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Treatment with Thalidomide and Cyclophosphamide (TCID) is Superior to Vincristine (VID) and to Vinorelbine (VRID) Regimens in Patients with Refractory or Recurrent Multiple Myeloma
Authors:Britta Auel  Hartmut Goldschmidt  Thomas Geer  Thomas M. Moehler  Uwe Platzbecker  Ralph Naumann  Igor Blau  Mathias H?nel  Wolfgang Knauf  Holger Nückel  Hans-Jürgen Salwender  Christof Scheid  Katja Weisel  Marcus Gorschlüter  Axel Glasmacher  Ingo G. H. Schmidt-Wolf  The German Refractory Myeloma Study Group
Affiliation:1. Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
2. Universit?tsklinikum, Heidelberg, Germany
3. Diakonie-Krankenhaus, Schw?bisch-Hall, Germany
4. Universit?tsklinikum, Dresden, Germany
5. Stiftungsklinikum, Koblenz, Germany
6. Charite, Berlin, Germany
7. Klinikum, Chemnitz, Germany
8. Praxis, Frankfurt, Germany
9. Universit?tsklinikum, Essen, Germany
10. Asklepios Klinik Altona, Hamburg, Germany
11. Universit?tsklinikum, K?ln, Germany
12. Universit?tsklinikum, T??bingen, Germany
Abstract:Treatment of relapsed or refractory multiple myeloma remains a challenge and novel treatment regimen are required. Here, a matched pair analysis was performed comparing TCID (thalidomide, cyclophosphamide, idarubicin, dexamethasone) treatment to the treatment of patients with VID (vincristine, idarubicin, dexamethasone) or with VRID (vinorelbine, idarubicin, dexamethasone) for relapsed or refractory multiple myeloma. In total, 197 patients were enrolled in multicenter trials. After matching for important prognostic variables 46 matched-pairs (total of 138 patients) could be analysed with regard to survival, toxicity and efficacy. Interestingly, a significant improvement of overall response rate (ORR) for TCID treatment compared to VID and VRID was found. In addition, TCID treatment also led to a significantly higher overall survival (OS) as well as progression-free survival (PFS) compared to VID and VRID. In conclusion, TCID treatment appears to be superior to VRID and VID treatment in patients with progressive or refractory myeloma.
Keywords:Myeloma   Thalidomide   Idarubicin   Vinorelbine   Dexamethasone
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